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Inside the Boiler Room: Disrupting Medical Imaging

Team Live Longer

Saving lives through early detection, using smartphones for remote diagnosis of patients in under-served areas.

Boiler Room Update (May 2015): AlexaPath won the American Society of Engineers (ASME) competition for Best Hardware Led Social Innovation. Also in May 2015, it’s manuscript on mobile Whole Slide Imaging (mWSI) was accepted for publication by the peer-reviewed medical journal, BMJ.

Lou Auguste is disrupting the medical imaging industry and cervical cancer diagnosis. Why? His company wants to reduce cervical cancer mortality rates by using smartphones to turn microscopes into medical imaging devices. He is specifically targeting under-served countries bereft of an adequate number of pathologists.

Auguste left the film industry for the tech startup life inside the boiler room. In the aftermath of the 2010 Haitian earthquake, he went to Haiti for a year to help with the recovery. Among a plethora of problems, Auguste witnessed hospital shortages and wanted to do something to help.

HR Avant-Garde spoke with Auguste in March 2015:

What are you disrupting?

Lou Auguste

We are disrupting the traditional microscopic imaging business while opening up the medical teleconsultation business. Your smart phone can now become a medical diagnostic and imaging tool.

Consider what MakerBot did to 3D printing. 3D printing had been around for over a decade before it was commercialized. What we are doing is analogous to how that company was able to bring 3D printing to market. They maintained margins with price points that made it accessible to a wide swath of consumers.

What problem are you trying to solve?

Medical imaging hardware is expensive, costing $30,000 at the lowest end and $100,000 on average. Our company takes any microscope and turns it into a whole slide imaging device. Instead of worrying about cameras and computers, we attach a smart phone to a microscope using an adapter. All the power is in the smart phone with the phone itself controlling the robotic stage.

With a shortage of pathologists in many developing countries, we offer a low cost solution for the scanning of medical images combined with more efficient and less expensive digital transport for diagnosis. We can match resources to needs – pathologists in wealthier countries can diagnose patients in developing countries. Specifically, what we have already accomplished is having pathologists in the US diagnose cervical cancer for patients in Haiti.

Who wins & who loses with this disruption?

Winners include anyone involved in medical education since an easier and less expensive way of archiving medical imaging is part of our disruption. Countries with a shortage of pathologists win because pathology can now be accomplished across borders with ease. And, of course, our primary winner: patients, because we are opening up a new market. Patients, who could not, in the past, access a pathologist, can now do so.

Currently, we are concentrating in Haiti where cervical cancer has a 93% mortality rate compared to 10% in the US. The US used to have a similar rate when people would not notice symptoms until it was too late. Yearly testing of cervical cancer in Haiti is now possible. Our innovation has driven down the costs.

What skills are most essential to your firm’s success, yet are in limited supply?

As a startup, we have low vertical integration. We source skill sets as we need them during this phase in our operations and find it challenging to find mechanical engineers with a background in machine learning.

Are you still looking for venture capital?

Yes. We are waiting to hit certain benchmarks before approaching VCs. We intend to:

Publish our findings in the British Medical Journal

Conclude a validation study of mWSI (Mobile Whole Slide Imaging), conducted with medical pathologists from the North Shore Long Island Jewish Hospital System

Submit designs to ASME (American Society of Mechanical Engineers)

What is your VC pitch?

Our technology can produce file images suitable for pathologists’ diagnoses at 500 megabytes compared to current sizes that are 20 times larger. We can transport more files across less broadband quicker and store them less expensively. Our hardware costs around $2,000 compared to the $30,000 to $100,000 range previously mentioned.

What is your exit strategy?

We are structuring our startup for eventual acquisition.

What is the biggest risk to your firm’s success?

We face regulatory risk of FDA approval of medical devices under a 510 (k) filing. This is why we built a strategy of working with the developing world. Not only is the need greater than in the United States, but the regulatory hurdles are more approachable. We intend to build momentum by working with government aid groups in the developing world to move quickly and to acquire more meaningful data points to build a stronger case for approval here in the US.

What key intellectual property has the company developed?

We filed for IP based on our acquisition model of the slides we collect through smart phones. We also filed a patent on our controlling method in how smart phones can control the robotic stages.

What metric best captures your firm’s success?

To reduce the mortality rate of cervical cancer in countries suffering from a shortage of pathologists.

What entrepreneur do you admire?

Richard Branson, because he has his hands in a lot of pies, and Elon Musk, because of the way he pushes technology to solve incredibly complex problems.

Tell us about a customer who was impacted by your product.

Our company is part of Team Live Longer, an initiative with AMHE (Haitian Physicians Abroad). We have been working with Haitian expatriate pathologists coming to Haiti for the last couple of years. There was one lab tech working at Justinien Hospital in Cap Haitien who said she wanted to get tested for HPB using our technology, but it was more personal than that because when she tested negative, she was relived. And in some small way, the quality of her life was the better for it.

What does transformational innovation of your product look like years from now?

In the future, I’d love to be able to have smart phones with machine learning algorithms as a means of detecting many forms of cancer in real time.

I love what I do. I’m afraid of working without a net, which is the nature of the entrepreneur creating from scratch, and of losing key people to more established companies. I regret not seizing opportunities earlier in life. For example, not working with USAID more when I first started.

If you wore a warning label, what would it say?

Early detection of cancer saves lives, so get tested early to live longer.